|
s�s-'iao-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � � Building Department
<br /> i
<br /> Date Rece�ve�d � •.Phone Contact for Permitting � �� 3 ��� — Slo T"2
<br /> i
<br /> Owner's Namle J d 5�6��/ �! �/�✓ Owner Phone Number
<br /> Owner's Address . ?"� J ,7 J ��� s� � Owner Phone Number
<br /> Fee Slmple T tleholder Name Owrner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS S TiS� S�l� LOT# �
<br /> SUBDIVISIO PARCEL ID# �T ' 2� `a l'6p10 � b/�d O �D�3 3 a
<br /> - (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED � .. NEW CONSTR B ADD/ALT Q SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE Q SFR Q COMM Q OTHER .
<br /> TYPE:OF COIPISTRUCTION Q BLOCK •- Q FRAME 0 STEEL Q
<br /> DESCRIPTIO OF WORK � ���Y �� /� 7 r G r� �� � �
<br /> - � Z_� r /
<br /> BUILDING SI�E SQ FOOTAGE� HEIGHT •
<br /> �BU�LDING $ VACUATION�OF TOTAL CONSTRIJCTION.
<br /> �5� .d0
<br /> QEI:�CTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING � $
<br /> QM CHANICAL $ VALUATION OF MECHANICAL INSTALLATION � l ���a
<br /> �I o
<br /> Q;GAi Q ROOFING Q SPECIALTY Q OTHER /`��
<br /> FINISHED F IOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER / J�� COMPANY �S�u /(i/✓C!-� Cp //✓�-
<br /> SIGNATURE ln/ REGISTERED Y'/ N FEE CURRE� Y/N
<br /> Address License#
<br /> -ELEC'I'RI.CI� COMPANY
<br /> . SIGNATURE REGISTERED Y/ N �FEE CURRE� Y/N
<br /> Address License# '
<br /> .�.
<br /> PLUMBER,; � COMPANY- ' '
<br /> -SIGNATURE -ReGlsTerteo Y./�N FEE CURRE� • Y/N
<br /> , Addre�s ' License# :
<br /> MECHl4NIC� COMP.ANX
<br /> SIGNATURB' REGISTERED , Y,/ N . `� , FEE CURRE� , . Y/N
<br /> . ,� , - -
<br /> Aild'ress�' License.#
<br /> ';;,i-,,.�• ; :
<br /> , OTHER� ."�:'°: ' �= � ' COMPANY"
<br /> �� SIGNqT.URE s, :_�; '� - � � REGISTERED Y/.N. FEE CURREK Y/N
<br /> ..:. � • , .,. - .
<br /> Addr �- � '°- License#
<br /> I�"�,
<br /> ;.:, ,..:� . � . .
<br /> ..';t: i ', "_ ' , Y ' 4.l ,
<br /> �r�,RESIDENTI,: �;� ''Attacii;:(2�);PlotiPlans;,'(2)+sefs�of�Builiiing�Plans;(1)�setof�Ene�gy`Forms;R=.O=W Perrriit.fornew.constructlon, .
<br /> ,_;��;,�•:;Mmimum;ten,(,10):wo,rking;days afte�sutimittal�date.• Requiretl orisite;�Construction"Plans;Storrnu'vater'Plans w/Silt Fence installed,
<br /> � �i Sani4a,ry�Facillties;&�-1s,dumpster:Site;WorkPermitforsutidivisions/large'.p'rojects� ' ` � =
<br /> �:C.OMMERGIA� Attacfi•�(2)'•comple4e'sets`ofBuildirig Plans pius a Lffe Safety Page;(1)set of Energy Fortns.R-O-W Permitfor new construcdon.
<br /> � � Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> ;;�_ Sanitary Facilitfes&1 dumpster.Site Work Permit"foF all-new p�ojects.All commercial requirements must meet compliance
<br /> �.:;SIGN;PERMIT "Attach°(2)setsoftEngineered,Pians:��.�•:
<br /> ,"��:�;" ""**PROPERTY SURVEY re wred for,..aII.NEW.construction..
<br /> _F� I . . 9-.__ ,
<br /> `'-�,-DiPections: II ���=.::i•..: ., . .< -
<br /> '" ��FIIG.out application completely.
<br /> �O.wnee&�Contraotor sig{�back of application,notarized
<br /> -If over'$2500,a Notice:of:Commencement is required. (A/C upgrades over$7500)
<br /> :.,.. P.. ..:�:,,, r:•:,:
<br /> Agent'(for th'e°contractorpor Power of`Attomey(for'tFie otivner)would tie someone with notarized letter from owner authorizing same
<br /> i.'�OVER'.THE COUNTER�,PERMI'RING...... _.(copy-of-contract required) '�" �
<br /> ;;�Reroofs if shi"ngles Sewers Service Upgrades A/C Fences(PIot/Survey/Footage)
<br /> . Drivew lys-Not over Counter if on.public roadways..needs ROW
<br /> II
<br />
|